Ritonavir (Protease Inhibitor for Treatment of HIV)

Drug Information

Ritonavir is used with other medications to treat human immunodeficiency virus (HIV) infection. Ritonavir is in a class of antiviral medications called protease inhibitors. It works by slowing the spread of HIV infection in the body.1

Ritonavir was approved by the FDA on March 1, 1996, for use with other antiretroviral agents in the treatment of HIV infection in adults and children 2 years of age or older. Ritonavir is now approved with other anti-HIV drugs in the treatment of HIV-1 infection in individuals over 1 month in age. Studies have shown that ritonavir works as a booster for some other protease inhibitors. Taking ritonavir makes it possible to take a lower dose of the other protease inhibitors.2

Norvir is Abbott Laboratories’ brand name for ritonavir. Kaletra or Aluvia are Abbott’s brand name for the HIV treatment that combines lopinavir and ritonavir.3

Ritonavir is a key component of HIV/AIDS treatment regimens worldwide.

Exclusive commercialization

In spite of the publicly-funded research that directly contributed to the development of ritonavir, Abbott still maintains the exclusive rights to commercialize ritonavir and lopinavir+ritonavir (LPV/r) in the United States and many low- and middle-income countries.4

Abbott prolongs its monopoly on Kaletra through its “patent-evergreening” strategy. Abbott has applied for new patents for slight modifications to the drug despite the fact that these alterations rarely change the drug’s therapeutic efficacy.

Generics

In countries which are members of the Clinton Health Access Initiative (CHAI) Procurement Consortium, WHO-prequalified generic LPV/r heat-stable is offered at a maximum price of 399 USD per person per year.5

There are multiple generic versions of ritonavir available, including versions prequalified by the World Health Organization – but only where patent barriers can be overcome.

Prices for generic LPV/r, including but not limited to heat-stable tablets, are significantly lower than Kaletra prices – up to 90% lower.

Peru has perhaps the global low price for LPV/r. By facilitating consistent competitive bidding between firms, Peru has obtained a price of $396 per person per year from Eske Group, a Cipla affiliate. Kaletra prices in middle income countries still often approach $4,000.6

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